Conservative surgical management for noninvasive distal ureteral carcinoma.

Distal ureterectomy with direct ureteroneocystostomy facilitated by the psoas bladder hitch procedure has been used in 6 patients for management of low-grade, noninvasive primary ureteral carcinoma. All patients are alive, two to ninety-six months postoperatively. Recurrent ipsilateral urothelial malignant disease has occurred in only 1 patient, twenty-six months postoperatively, necessitating a secondary nephroureterectomy. Renal function has been preserved in the remaining 5 patients. The continued practice of conservative surgery in these cases appears warranted.